Latham v. Lincoln National Life Insurance

133 F. Supp. 3d 875, 2015 U.S. Dist. LEXIS 125680, 2015 WL 5595503
CourtDistrict Court, E.D. Kentucky
DecidedSeptember 21, 2015
DocketCivil Action No. 5:15-141-DCR
StatusPublished
Cited by2 cases

This text of 133 F. Supp. 3d 875 (Latham v. Lincoln National Life Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Latham v. Lincoln National Life Insurance, 133 F. Supp. 3d 875, 2015 U.S. Dist. LEXIS 125680, 2015 WL 5595503 (E.D. Ky. 2015).

Opinion

MEMORANDUM OPINION AND ORDER

Danny C. Reeves, United States District Court Judge

This matter is pending for consideration of Plaintiff Eileen Latham’s motion for an order regarding whether this action is governed by the Employee Retirement Income Security Act (“ERISA”). 29 U.S.C. §§ 1001, et seq. [Record No. 19] Latham claims that removal under 28 U.S.C. § 1441(a) is improper insofar as it is premised on the existence of a federal question. 28 U.S.C. § 1331. [Record No. 19-1, p. 4] Specifically, she argues that the long-term disability benefits she received from the defendant are not governed by ERISA. [7d] Defendant Lincoln National Life Insurance Company (“Lincoln”) contends that removal is proper because the benefits form part of a larger “Plan” governed by ERISA. [Record No. 20] For the reasons outlined below, the Court concludes that ERISA governs Latham’s claims regarding long-term disability benefits.

[879]*879I.

While employed at Nurses Registry and' Home Health Care (“Nurses Registry”) in Fayette County, Kentucky, Eileen Latham elected to become insured under a long-term disability insurance (“LTD”) policy with The Lincoln National Life Insurance Company. [Record.No. 1-1, p. 5] Lincoln provided a LTD policy, among other insurance policies, to employees of Nurses Registry. [Id.; Record No. 20-2, p. 6, “Application for Group Insurance”] The plaintiff alleges that she became disabled under the terms of the LTD policy in July of 2012. [Record No. 1-1, p. 6] On January 18, 2013, the defendant approved her claim for partial LTD benefits effective October 8, 2012. [Id.]

In September 2012, Latham became employed part-time, consistent with her partial disability benefits. [Record No. 19-1, p. 1] However, by letter dated May 1, 2014, Lincoln informed her that she was no longer eligible to continue receiving LTD benefits beyond October 8, 2014. [Record No. 1-1, p. 6] Latham subsequently appealed, and Lincoln affirmed its earlier decision by letter dated July 12, 2014. [Id.] The plaintiff then filed a second-level appeal. By letter dated December 9, 2014, the defendant again affirmed its prior determination. [M]

Having exhausted her administrative remedies, Latham filed suit against Lincoln in the Fayette Circuit Court on April 21, 2015, asserting breach of contract and negligence claims. [Record No. 1-1, pp. 4, 7] On May 19, 2015, Lincoln filed a Notice of Removal, alleging both diversity and federal-question jurisdiction.1 28 U.S.C. §§ 1331, 1332, 1441, 1446. [Record No. 1, p. 1] Specifically, Lincoln asserted that Latham’s LTD policy is part of an employee welfare benefit plan governed by ERISA. 29 U.S.C. §§ 1001, et seq.

On July 16, 2015, this Court directed the parties to submit briefs addressing whether ERISA governs the claims asserted by Latham. [Record No. 17] In support of her motion, Latham contends that disability benefits fall within ERISA’s “safe harbor” as set forth in 29 C.F.R. § 2510.3-1(j). [Record No. 19-1, p. 5] She further asserts that LTD coverage is not part of a “plan” that is “established or maintained” by Nurses Registry. [Id., pp. 13, 15] In response, Lincoln claims that the benefits fall outside the safe harbor and that they form part of an ERISA plan established and maintained by Nurses Registry. [Record No. 20, pp. 4, 14, 15]

II.

Under 28 U.S.C. § 1441(a), a defendant may remove any civil action brought in a state court if the district court would have original jurisdiction. District courts have original jurisdiction of all civil actions arising under the Constitution, laws, or treaties of the United States. 28 U.S.C. § 1331. For removal premised on federal-question jurisdiction, the burden is on the party seeking removal. Long v. Bando Mfg. of Am., Inc., 201 F.3d 754, 757 (6th Cir.2000).

This Court undertakes a three-step inquiry in determining whether ERISA governs an employee welfare benefit plan. First, it applies the “safe harbor regulations” of the Department of Labor. Thompson v. Am. Home Assurance Co., 95 F.3d 429, 434-35 (6th Cir.1996) (referring to 29 C.F.R. § 2510.3-1(1)). Next, the court determines whether a “plan” exists. Id. at 435. Third, it asks whether the employer [880]*880“established or maintained” the plan with the intent of providing benefits to its employees.” Id. As described below, Latham’s LTD policy does not fall within the exemption. Further, Nurses Registry established and maintained a plan with the intent of providing benefits to its employees.

A. Safe Harbor

Under 29 C.F.R. § 2510.3-Kj), insurance programs do not qualify as “employee welfare benefit plans” subject to ERISA if all of the following criteria are met: (1) the employer makes no contributions to the program; (2) participation in the program is completely voluntary for employees; (3) the employer does not endorse the program; and (4) the employer receives no consideration in connection with the program, excluding reasonable compensation for administrative services. Fugarino v. Hartford Life & Accident Ins. Co., 969 F.2d 178, 183 (6th Cir.1992) (A program is exempted from ERISA only if all four criteria are met.).

Latham claims that Lincoln has not shown that the long-term disability benefits she received fall out of the exemption set forth in 29 C.F.R. § 2510.3-l(j). [Record 19-1, pp. 5-13] Lincoln, on the other hand, contends that the safe harbor does not apply to Latham’s benefits for two reasons. [Record No. 20, p. 4] First, it asserts that Nurses Registry made contributions to the overall “Plan” governing Latham’s LTD benefits. [Id., pp. 5-9] Second, it argues that Nurses Registry “endorsed” the plan of which the LTD benefits were a part. [Id., pp. 9-14] Lincoln concedes that the other two factors (i.e., that employees participated voluntarily in the program and that Nurses Registry received no meaningful compensation) are not applicable to Latham’s case. [Id., p. 13]

1. Contributions

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133 F. Supp. 3d 875, 2015 U.S. Dist. LEXIS 125680, 2015 WL 5595503, Counsel Stack Legal Research, https://law.counselstack.com/opinion/latham-v-lincoln-national-life-insurance-kyed-2015.